Journal of the American College of Surgeons study authors report that, after implementation of the publicly funded state trauma system, preventable mortality rate decreased by 48 percentCHICAGO (March 8, 2017): Implementation of a statewide trauma system in Arkansas cut the rate of preventable deaths due to injuries nearly in half over five years and saved 79 lives over a 12-month period, authors of a new study estimate. The study appears online as an “article in press” on the Journal of the American College of Surgeons website in advance of print publication.
From their analysis of the economic impact of lives saved, the study investigators concluded that the Arkansas Trauma System annually saved $186 million, giving state taxpayers a roughly ninefold return on investment (ROI) from the $20 million per year in public funding the system has received.
“The evidence is clear that a statewide trauma system helps trauma patients by reducing complications and deaths, but now we also know there is an economic value to the citizens in having a statewide trauma system,” said principal investigator Charles Mabry, MD, FACS, an associate professor of surgery at the University of Arkansas for Medical Sciences, Little Rock.
Dr. Mabry said he believes this study is the first one to evaluate a state trauma system’s ROI to taxpayers. He noted that the trauma systems in most states are regional rather than statewide, typically making it difficult to track a system’s statewide impact.
Before Arkansas launched its trauma system in 2010, it was one of the few states without an organized trauma system and the only one without state-designated trauma centers according to the Arkansas Department of Health.*
When this study began in 2015, the trauma system had the participation of most hospitals in the state, with 58 designated trauma centers, Dr. Mabry reported. It also gained a trauma communications center, including a web-based dashboard that lists trauma centers’ services and up-to-date capacity, which he said enables emergency medical services (EMS) to transport patients to the nearest appropriate and available trauma center.
To determine the benefits of the new trauma system, the investigators first performed a preventable mortality, or death, analysis for two periods: the year before implementation of the system, 2009, and a one-year period after the system was in place, April 2013 to March 2014. Using EMS (prehospital), hospital, and autopsy records for both periods, they found that approximately 2,500 people died of trauma each year. They then selected a sample of 290 people representative of those who died of trauma in 2009 and a similar representative 382 in 2013-2014.